Deep Dives Level Up Newsletters Saved Articles Challenges

Meet James Elist, the doctor who made penile implants happen

By Alma Fabiani

Jan 30, 2021


In the US alone, the question ‘Does penis size matter?’ is searched a thousand times a month, while ‘ideal penis size’ racks up more than 1,700 monthly searches. Looking at those numbers, it’s clear that penis size remains an important topic for many, and that penis shaming—also known as penile humiliation or even dick shaming—still affects penis owners all around the world.

But self-penis shaming is an even bigger problem. Although our body-shaming culture doesn’t openly point to ‘bad’ genitals, culture, media, and most of all porn would imply otherwise. That’s where Doctor James Elist comes in as the inventor of Penuma, the first and only FDA-cleared silicone implant for penile enhancement. Screen Shot spoke to Doctor Elist to find out more about the world of penile implants and the promising future it holds.

Prior to Penuma, the only penile implants available were designed to treat erectile dysfunction—not to enhance penile size. In other words, there were no penis enlargement implants available before Doctor James Elist came along. “Penuma takes the concept of a breast implant and applies it to the context of a penis. The insertion procedure is relatively straightforward. There is an incision made in the pubic area above the penis or an incision in the scrotal area, and the implant is inserted from there,” explains Doctor Elist. For this procedure, there are no incisions on the penis itself.

About 60 per cent of the 160 million men in the US feel their penis size impacts their life. That’s a lot of self-penis shaming, if you ask me. Similar to what Doctor Frank Gerow and Doctor Thomas Cronin did with inventing the silicon breast for women, Doctor Elist has done it for thousands of men, inch by inch, penis by penis.

We’ve previously witnessed the rise of vaginal surgery as a trend along with vaginal beauty, which led me to ask Doctor Elist whether he thought the same was happening with penis implants. “Absolutely. As more physicians offer Penuma (we currently have 10 highly experienced prosthetic urologists in the US, many of whom are professors of urology, who are conducting the procedure almost every day) and as more data are presented on its safety and efficacy, we have seen more people excited to explore Penuma for themselves. Even during 2020 with the COVID-19 pandemic, we have seen an increase of 20 per cent in web traffic and a similar increase in patient volume,” Elist told me.

But what first led the urologist to create Penuma? As Doctor Elist explained, “For years, I would hear the classic question from patients of ‘Hey Doc, how can I make it bigger down there?’ This is a question many urologists hear. Unfortunately, the only options at the time prior to Penuma (such as fat injection or fillers) tended to cause damage to the penis.”

In fact, the American Urological Association (AUA) put out a statement that clearly showed the risks these previous procedures presented. Nevertheless, men continued to pursue damaging procedures in places such as Tijuana or Vietnam. “We developed Penuma by taking a scientific approach. We consulted with biomedical engineers and conducted a series of clinical studies before receiving our first FDA clearance in 2004. Since then, we have partnered with top prosthetic urologists at institutions such as Harvard, Mt. Sinai, and Rush University, we have published the results of our IRB-approved, 400 patient, 5-year retrospective review in a peer-reviewed journal as well as other academic articles on Penuma, and we have successfully performed thousands of procedures across the US,” Elist added.

In order to truly find out the impact that Penuma’s breakthrough has had on penis owners, Screen Shot reached out to one of its patients who chose to remain anonymous. “I had a urological issue which prompted me to look for the best-rated doctors in the country. That brought me to Doctor Elist’s work and I found it compelling, exciting and cutting-edge so I decided to undergo the surgery as an adventure in tandem with my other needs. What guy doesn’t want a larger package? It was a no brainer for sure,” shared the patient.

When asked about how he feels now that he’s gone through the procedure, he added, “I’ve always been confident and satisfied with my penis and my sex life. But the implant has definitely made me even more comfortable and confident. Like a woman who gets breast implants—we should normalise the ability to adjust your appearance to whatever makes the person feel good. Especially being a gay man, I now get a lot of attention and positive reinforcement about it. I always share that I have the implant so people know that I’ve augmented its appearance and they’re usually floored. By having the implant I’m able to talk about body image issues with men I otherwise wouldn’t and I think that’s powerful.”

Speaking to Doctor Elist, it seems that Penuma has won over patients from all walks of life. “20 to 25 per cent of our patients come from abroad, and we have a wide diversity in terms of ethnicity, age (all over 21), and sexual orientation.” But as he further explains, as safe as the procedure has proved itself to be, not every patient with a small-sized penis should go through it. “We are focused on patient safety first and foremost, which is why we published a protocol on patient selection with strict standards on which patients we will and will not operate on.”

Of course, I truly believe that, although men with smaller penises are often pushed to feel ‘less masculine’ or even unable to please others, both of these assumptions are wrong. And in its own way, Penuma could help shift society’s toxic standards about masculinity. “We hope that every patient finds self-confidence and self-esteem from within but we also understand that there are often psychological elements at play with the decision to pursue penile enhancement. This is why we use a psychological screener with all patients, and will often refer patients to a therapist. If a patient is able to address any anxieties through therapy, then this is a win-win as the patient avoids surgery. However, if the patient and the therapist both feel that the Penuma implant is a good option for the patient, then we will continue the discussion,” shared Doctor Elist.

It’s about time we normalise cosmetic procedures for men—that it’s okay for a man to want to look good. From penile implants and tummy tucks to liposuction and fillers men are also going under the knife, and there’s nothing wrong with that. After all, as Doctor Elist’s patient told me, “Nature has to take its course with gravity and stick to the new timeline and expectations provided to you by doctors.”